Clinical and radiological response and side effects of beta interferon in Iraqi patients with relapsing and remitting multiple sclerosis

OBJECTIVE: To determine the efficacy and tolerability of subcutaneous Interferon beta 1a (IFNbeta-1a) among Iraqi patients with relapsing remitting multiple sclerosis (RRMS).

METHODS: The study was held at the Multiple Sclerosis clinic at Baghdad Teaching Hospital, Baghdad, Iraq from January-October 2004. Thirty-seven patients with clinically definite RRMS and disability status scale below 6.5 were enrolled in this study. Patients received IFNbeta-1a, 22 ug subcutaneously 3 times a week. Clinical measures, including number of relapses and disability progression, with MRI measures including number, size activity of lesions, and brain atrophy were used for evaluation of response to treatment. Side effects were also looked for.

RESULTS: Patient ages ranged between 17-60 years with a mean age of 34.85 years, with 20 female patients and 17 male patients. After 2 years of treatment, there was a significant reduction in relapse rate (54.1% were relapse free, and 21.6% had reduction in relapse rate). There was also a significant effect on disability progression (the mean expanded disability status scale (EDSS) before treatment was 3.22 and mean EDSS after treatment was 2.84). Significant effects on MRI measures were also shown, presented by a reduction in the number of lesions, which was seen in 64.9% of the patients, and a reduction in the size of lesions, which was seen in 64.9% of the patients. Also, significant effects on the activity of lesions was seen, as 67.6% of the patients had non-active lesions before treatment and remained non-active after treatment, and 29.7% of the patients had active lesions before treatment, which became non-active after 2 years of treatment. Mild adverse reactions were seen, mainly influenza like reactions and injection site reactions.

CONCLUSION: Interferon beta-1a was effective in the treatment of RRMS with minimal side effects.